Can PTSD Cause Someone to Develop a Substance Use Problem?

Key Takeaways

• Post-traumatic stress disorder (PTSD) does not directly cause addiction, but it raises the risk of a substance use problem.
• More than 4 in 10 U.S. adults with PTSD also have problems with alcohol or drug use, according to the U.S. Department of Veterans Affairs (VA).
• For most people who have both conditions, PTSD comes first, and substances are often used to cope with symptoms.
• Alcohol and drugs can make PTSD symptoms worse, so the two conditions can feed each other.
• Gateway Rehab is an expert substance misuse treatment provider in Western Pennsylvania offering integrated treatment for co-occurring disorders. Reach out to start recovery.

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Does PTSD Cause Addiction? What the Research Shows

PTSD is a mental health condition that can follow a frightening or harmful event, such as an assault, an accident, a disaster, or combat. About 6 out of every 100 people will have PTSD at some point in life, according to the National Institute of Mental Health (NIMH).

Most people with PTSD never develop a substance use disorder. A substance use disorder is a medical condition in which a person keeps using alcohol or drugs even though it causes harm. Still, the overlap is large. The VA reports that over 4 out of 10 U.S. adults with PTSD also have problems with drug or alcohol use.

The order matters too. For most people who have both conditions, PTSD develops first, and the substance use follows.

Trauma and Substance Abuse: How the Cycle Forms

Many people with PTSD use alcohol or drugs to cope. This is often called self-medicating, which means using a substance to ease painful symptoms without medical guidance. The VA says people may use substances to relax, to feel more comfortable around others, or to avoid thoughts and feelings they would rather not face.

The link can also run the other way. Alcohol and drugs can impair judgment, which raises the risk of accidents and injuries. Those events can be traumatic and may lead to PTSD.

PTSD and Drug Abuse: Why Relief Does Not Last

A substance may seem to help at first. The table shows how short-term relief can turn into a new problem, using information from the VA and NIMH.

Over time, the substance can become a problem of its own. The VA also notes that people with both conditions have a higher risk of depression, anxiety, and suicide.

Why PTSD and Substance Use Rarely Improve on Their Own

When both conditions are present, each one can keep the other going. Trauma symptoms drive use. Use makes symptoms worse. The Substance Abuse and Mental Health Services Administration (SAMHSA) says it is not always clear which came first. A mental health condition may be caused by substance use, a person may use to cope, or the two may be separate. Sorting this out is critical because it guides treatment.

SAMHSA also reports that most people with co-occurring disorders receive treatment for only one condition or none at all.

Co-Occurring Disorders Treatment: Treating Both Together

A co-occurring disorder means a person has both a mental health condition and a substance use disorder at the same time. SAMHSA calls integrated care, where both are treated together, the preferred model. The VA agrees: research shows that treating PTSD and substance use at the same time works for both.

For PTSD itself, the VA says trauma-focused therapies work best. Those with the strongest evidence include:

• Cognitive Processing Therapy (CPT), which helps people examine and reframe thoughts that formed around trauma.
• Prolonged Exposure, which helps people face trauma memories in a safe way.
• Eye Movement Desensitization and Reprocessing (EMDR), which helps people process traumatic memories so they feel less distressing.

Gateway Rehab's integrated treatment for co-occurring disorders is built around this approach. Its residential program treats addiction and mental health together, at the same time, with the same dedicated clinical team. Patients receive:

• A dedicated therapist who meets with them at least once a week.
• A dedicated case manager who helps plan housing, medical care, and care after discharge.
• Weekly visits with a psychiatric team to review medications and mental health.
• Nurses on the unit around the clock, who also provide Medication Assisted Recovery (MAR) when it is part of the plan. MAR uses medications approved by the U.S. Food and Drug Administration to reduce cravings and manage withdrawal.
• On-site EMDR and CPT for trauma.
• Five therapy and skill-building groups each day.

After residential care, patients can step down to outpatient care or telehealth and keep access to the psychiatric team.

When to Consider a Co-Occurring Disorders Evaluation

Consider an evaluation if you notice any of these signs:

• You use alcohol or drugs to cope with memories, nightmares, or feeling on edge.
• Trauma symptoms seem worse after using, or louder when you try to stop.
• Past substance use treatment did not last.
• A painful experience in your past has never been directly addressed.

An evaluation is a conversation with a clinical team, not a commitment to a specific program. It helps show whether trauma is part of the picture.

Get PTSD and Addiction Treatment That Treats Both at the Same Time

PTSD does not directly cause addiction, but it raises the risk, and the two conditions can keep each other going. Treating both together is the approach research supports.

Gateway Rehab, an expert substance misuse treatment provider in Western Pennsylvania, offers integrated treatment for co-occurring disorders, including PTSD and addiction. If you or someone you love is living with both, reach out to start recovery or learn more about Gateway Rehab and its programs.

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